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Gaining a few pounds may increase long-term heart failure risk

AHA Heart News - Wed, 07/19/2017 - 15:19
Study Highlights

  • Modest weight gain over time may alter the structure and function of heart muscle, affecting long-term risk of heart failure.
  • Researchers say maintaining weight and avoiding weight gain may be an important strategy to prevent changes in heart muscle that could lead to heart failure.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, July 19, 2017

DALLAS, July 19, 2017 — Gaining even a little weight over time may alter the structure and function of heart muscle, affecting long-term risk of heart failure, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Researchers followed 1,262 adults (average age 44, 57 percent women, 44 percent black, 36 percent obese) who were free from heart disease and other conditions that put them at high risk for heart disease for seven years. Participants had MRIs scans of their hearts and multiple body fat measurements at the start of the study and then seven years later.

Researchers found those who gained weight:

  • even as little as 5 percent, were more likely to have thickening and enlargement of the left ventricle, well-established indicators of future heart failure;

  • were more likely to exhibit subtle decreases in their hearts’ pumping ability; and

  • were more likely to exhibit changes in heart muscle appearance and function that persisted even after the researchers eliminated other factors that could affect heart muscle performance and appearance, including high blood pressure, diabetes, smoking and alcohol use.

Conversely, people who lost weight were more likely to exhibit decreases in heart muscle thickness.

Notably, how much a person weighed at the beginning of the study didn’t impact the changes, suggesting that even those of normal weight could experience adverse heart effects if they gain weight over time, researchers said.

“Any weight gain may lead to detrimental changes in the heart above and beyond the effects of baseline weight so that prevention should focus on weight loss or if meaningful weight loss cannot be achieved – the focus should be on weight stability,” said Ian Neeland, M.D., study senior author and a cardiologist and assistant professor of medicine at University of Texas Southwestern Medical Center in Dallas, Texas. “Counseling to maintain weight stability, even in the absence of weight loss, may be an important preventive strategy among high-risk individuals.”

The researchers caution that their study was relatively small and their findings do not mean that every person with weight gain will necessarily develop heart failure. The results do suggest that changes in weight may affect heart muscle in ways that can change the organ’s function.

Further research is needed to determine whether aggressive weight management could, reverse the changes, Neeland said.

Co-authors are Bryan Wilner, M.D.; Sonia Garg, M.D.; Colby Ayers, M.S.; Christopher D. Maroules, M.D.; Roderick McColl, Ph.D.; Susan A. Matulevicius, M.D.; James A. de Lemos, M.D.; Mark H. Drazner, M.D. and Ronal Peshock, M.D. Author disclosures and funding are on the manuscript.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Karen Astle: 214-706-1392; karen.astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsWed, 19 Jul 2017 20:00:10 GMTStudy Highlights: Modest weight gain over time may alter the structure and function of heart muscle, affecting long-term risk of heart failure. Researchers say maintaining weight and avoiding weight gain may be an important strategy to prevent changes in heart muscle that could lead to heart failure. http://newsroom.heart.org/news/gaining-a-few-pounds-may-increase-long-term-heart-failure-riskWed, 19 Jul 2017 20:00:00 GMT

Government funds dwindle for cardiac arrest research

AHA Heart News - Wed, 07/12/2017 - 15:51
Study Highlights

  • Despite being a leading cause of death, annual National Institutes of Health (NIH) investment in cardiac arrest research is a fraction of the dollars spent to research other deadly conditions.
  • In 2015, $91 was invested in cardiac arrest research per death compared to $13,000 per diabetes death.
  • This is the first study to examine the trend in annual cardiac arrest research funding in the United States.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, July 12, 2017

DALLAS, July 12, 2017 — National Institutes of Health (NIH) funding to conduct cardiac arrest research has dwindled in the last decade and is a fraction of what the government spends to study other leading causes of death, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Study authors cite Institute of Medicine statistics that suggest cardiac arrest is the third leading cause of death in the United States, claiming more than 450,000 lives each year.

“If you look at the public health burden of cardiac arrest, it’s a major public health issue,” said senior study author Robert Neumar, M.D., Ph.D., professor and chair of the University of Michigan Health System’s Department of Emergency Medicine in Ann Arbor Michigan. “Right now, if someone has a sudden cardiac arrest outside the hospital, they have a less than one in 10 chance of surviving. If they have a sudden cardiac arrest inside the hospital, they have a one in four chance of surviving.”

Cardiac arrest is treatable when people, including bystanders, know what to do and act quickly, according to lead study author Ryan A. Coute, a medical student at Kansas City University of Medicine and Biosciences, who conducted the research while completing a fellowship at University of Michigan. “Funding of cardiac arrest research is a critical step towards improving survival of cardiac arrest,” Coute said.

Researchers studied NIH trends in cardiac arrest research funding from 2007 to 2016 and compared the investment in cardiac arrest research to that of other leading causes of death in the United States.

In 2015, NIH investment breakdown was:

  • $13,000 for each death from diabetes;
  • $9,000 per cancer death;
  • $2,200 for each stroke fatality;
  • $2,100 for each death from heart disease; and
  • $91 for each death from cardiac arrest.

Overall, cardiac arrest research funding decreased during the last decade.

In 2007, adjusted for inflation, funding was $35.4 million but was down nearly 7 million to $28.5 million in 2016.

Cardiac research received about 0.19 percent of the total NIH research grant funding in 2015.

While there has been an increase in research funding for pediatric cardiac arrest and cardiac arrest training during the past decade, little to no growth has occurred in the number of funded researchers, newly funded grants and overall funded grants from the NIH.

Unlike diseases, which often receive research funding from industry, including pharmaceutical companies or medical device makers, cardiac arrest rarely receives funding from outside sources and relies heavily government research dollars, the authors wrote.

“One of the challenges could be that we don’t have enough scientists applying for grants in cardiac arrest research,” Neumar said. “It could also be a chicken or the egg scenario where there isn’t enough money to do research, so researchers study other diseases.”

This study is the first to provide a detailed picture of the trend in annual cardiac arrest research funding in the United States.

“Although our results do not demonstrate the cause in this apparent funding disparity, they should help inform the debate regarding optimal funding of cardiac arrest research in the U.S.,” Coute said.

Other co-authors are Ashish R. Panchal, M.D., Ph.D., and Timothy J. Mader, M.D. Author disclosures are on the manuscript.

The Sarnoff Cardiovascular Research Foundation supported Ryan Coute, who was a research fellow during this study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Bridgette McNeill: 214-706-1135; bridgette.mcneill@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsWed, 12 Jul 2017 20:00:08 GMTStudy Highlights: Despite being a leading cause of death, annual National Institutes of Health (NIH) investment in cardiac arrest research is a fraction of the dollars spent to research other deadly conditions. In 2015, $91 was invested in cardiac arrest research per death compared to $13,000 per diabetes death. This is the first study to examine the trend in annual cardiac arrest research funding in the United States. http://newsroom.heart.org/news/government-funds-dwindle-for-cardiac-arrest-researchWed, 12 Jul 2017 20:00:00 GMT

Blacks suffer higher rates of fatal first-time heart attacks than whites

AHA Heart News - Mon, 07/10/2017 - 15:10
Study Highlights

  • Black adults, ages 45-64 years of age, are twice as likely to die during their initial cardiac event as white adults.
  • However, the risk for nonfatal coronary heart disease is consistently lower among black men versus white men.

Embargoed until 3 p.m. CT / 4 p.m. ET Monday, July 10, 2017  

DALLAS, July 10, 2017 — Black men may have similar risk of coronary heart disease as white men, but their first cardiac event is twice as likely to be fatal. That means preventing a first heart attack is even more crucial for blacks, according to research findings reported in the American Heart Association’s journal Circulation.

In an analysis that examined cardiac events in three major heart studies, researchers found that in two of these studies, black adults aged 45-64 have about twice the risk of fatal events compared with whites. The same is true for older individuals, with less pronounced differences. The study found that this high risk may be due to cardiovascular risk factors and the conditions in which people are born, grow, work and live – known as social determinants of health.

However, the findings differed for nonfatal events. Accounting for these same factors resulted in lower risk of nonfatal events in black men compared to white men, with similar patterns among women that were not statistically significant. According to the researchers, blacks have a higher burden of unfavorable social determinants of health and cardiovascular risk factors, so the lower risk of nonfatal cardiac events among blacks, especially black men, after accounting for these factors was surprising. These findings suggest that some other factor that the researchers could not measure may be driving the findings.

“Our concern is that blacks may not be seeking medical attention for important symptoms that could signal heart problems,” said Monika Safford, M.D., senior author and John J. Kuiper Professor of Medicine and Chief of General Internal Medicine at Weill Cornell Medical College in New York. “Greater public awareness of heart attack symptoms would benefit everyone. Many people think that heart attacks are only present if they have severe chest pain. In fact, many heart attacks cause only mild symptoms and people may mistakenly think they are having a bout of indigestion.” If the heart condition is not recognized, medications that save lives after a heart attack cannot be offered.

The lead author of the study is Lisandro Colantonio, M.D., Ph.D.; and co-authors are Christopher Gamboa, MPH; Joshua Richman, M.D., Ph.D.; Emily Levitan, ScD; Elsayed Soliman, M.D.; and George Howard, ScD.

Author disclosures are on the manuscript.

The National Institute of Neurological Disorders and Stroke; the National Institutes of Health, Department of Health and Human Services; and the National Heart, Lung, and Blood Institute supported this study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Carrie Thacker: 214-706-1665; carrie.thacker@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsMon, 10 Jul 2017 20:00:10 GMTStudy Highlights: Black adults, ages 45-64 years of age, are twice as likely to die during their initial cardiac event as white adults. However, the risk for nonfatal coronary heart disease is consistently lower among black men versus white men. http://newsroom.heart.org/news/blacks-suffer-higher-rates-of-fatal-first-time-heart-attacks-than-whitesMon, 10 Jul 2017 20:00:00 GMT

Health insurance expansion via Obamacare linked to fewer cardiac arrests

AHA Heart News - Wed, 06/28/2017 - 15:31
Study Highlights

  • The incidence of cardiac arrest significantly decreased among middle-aged adults who acquired health insurance after the Affordable Care Act (Obamacare) expanded coverage.
  • Among older adults with constant health insurance coverage, the incidence of cardiac arrest remained the same.
  • These preliminary findings highlight the importance of preventive medical care but do not definitively prove that health insurance expansion prevents cardiac arrest, researchers noted.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, June 28, 2017

DALLAS, June 28, 2017 — A sudden catastrophic loss of heart function, or cardiac arrest, occurred significantly less among adults who acquired health insurance via the Affordable Care Act (ACA), according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

In a study of emergency medical services in an urban Oregon county before and after the ACA, researchers noted that the incidence of cardiac arrest was significantly lower among middle-aged adults after they gained health insurance through the ACA, primarily through Medicaid expansion.

Among adults between 45 and 64 years old, the incidence of cardiac arrest decreased by 17 percent. In contrast, the incidence remained the same among adults over age 65 with consistently high rates of health insurance coverage, primarily through Medicare.

“Cardiac arrest is devastating and under-recognized cause of premature death for both men and women older than 45 years,” said study lead author Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University’s Knight Cardiovascular Institute in Portland, Oregon. “Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest.”

In the United States, more than 350,000 cases of out-of-hospital cardiac arrest happen each year. Cardiac arrest occurs when the heart’s regulatory system suddenly malfunctions, causing an abnormal heart rhythm. Death occurs if immediate medical attention, including CPR, isn’t started after cardiac arrest.

In this study, researchers used records for emergency medical services in Multnomah County, Oregon, to identify patients with out-of-hospital cardiac arrest. They then compared this information to U.S. Census Bureau data for the county’s adult population in the years before ACA implementation (2011-2012) and after ACA implementation (2014-2015). The study was part of a larger research project led by the study’s senior author Sumeet Chugh, M.D., director of the Heart Rhythm Center at Cedars-Sinai Heart Institute in Los Angeles.

“These findings underscore the important role of prevention in the battle against sudden cardiac arrest, which affects almost a thousand Americans every day,” Chugh said. “Less than 10 percent of these patients make it out of the hospital alive, so by the time we dial 9-1-1 it is much too late. For this reason, effective primary prevention is vital.”

Although the results of this small, preliminary study show an association between health insurance and lower rates of cardiac arrest, they do not prove cause and effect. To prove that health insurance decreases the rate of cardiac arrest, it is necessary to do larger studies that control other possible influences and include more diverse groups of patients.

Still, the results confirm the American Heart Association’s support of the ACA’s expansion of Medicaid and other health insurance coverage.

“It is critical to more comprehensively identify the health benefits of insurance and to carefully consider public policies that affect the number of uninsured Americans,” Stecker said.

In an accompanying editorial Mary Fran Hazinski, R.N., MSN, and Carole R. Myers, Ph.D., RN., note expanded Medicaid services have reduced deaths in other states but call these findings “intriguing.”

“The hypothesized relationship between healthcare expansion and decline in [out-of-hospital cardiac arrest] incidence is certainly a timely question that requires further study,” they wrote.  “A follow-up study should be based on a framework that looks more broadly at a complement of social and other determinants of health, and accounts for the various dimensions of access, and evaluates access by looking at utilization.”

Hazinski is a former consultant for the American Heart Association.

Co-authors are Kyndaron Reinier, Ph.D., M.P.H.; Carmen Rusinaru, M.D., Ph.D.; Audrey Uy-Evanado, M.D.; Jonathan Jui, M.D., M.P.H.; and Sumeet Chugh, M.D. Author disclosures are on the manuscript.

The National Heart Lung and Blood Institute funded the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Bridgette McNeill: (214) 706-1134; bridgette.mcneill@heart.org  

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsWed, 28 Jun 2017 20:00:09 GMTStudy Highlights: The incidence of cardiac arrest significantly decreased among middle-aged adults who acquired health insurance after the Affordable Care Act (Obamacare) expanded coverage. Among older adults with constant health insurance coverage, the incidence of cardiac arrest remained the same. These preliminary findings highlight the importance of preventive medical care but do not definitively prove that health insurance expansion prevents cardiac arrest, researchers noted. http://newsroom.heart.org/news/health-insurance-expansion-via-obamacare-linked-to-fewer-cardiac-arrestsWed, 28 Jun 2017 20:00:00 GMT

Hospitalizations for heart failure on the decline; disparities remain for blacks and men

AHA Heart News - Tue, 06/27/2017 - 15:38
Study Highlights

  • Heart failure hospitalizations in the United States have declined overall but remain significantly higher among blacks.
  • While still hospitalized more than whites, the disparity narrowed between Hispanics and whites.
  • Men were hospitalized more than women.

Embargoed until 3 p.m. CT / 4 p.m. ET Tuesday, June 27, 2017

DALLAS, June 27, 2017 – The number of people hospitalized for heart failure in the United States declined about 30 percent between 2002 and 2013, but large disparities between blacks vs. whites and men vs. women remain, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

The study is the first to report on the age-standardized racial/ethnic differences in national heart failure hospitalization rates between whites, blacks, Hispanics and Asians/Pacific Islanders.

Researchers examined data from the National Inpatient Survey from 2002-2013, which consisted of data from 7-8 million hospital discharge per year across thousands of hospitals.

They found:

  • Overall, the national rate of heart failure hospitalization decreased by about 30 percent.
  • Hospitalization rates for heart failure in men grew to be 39 percent higher than women.
  • Hospitalization rates for heart failure in blacks was more than 200 percent higher than for whites with no significant change over the period.
  • The rate for Hispanics dropped much faster than for whites with the disparity between the two groups narrowing to just 4 percent higher among Hispanic men, and decreasing from an initial 55 percent higher rate among Hispanic women in 2002 to only 8 percent higher in 2013.

The decrease in hospitalization rates suggest that efforts to improve outpatient treatment and prevention measures have successfully reduced the number of heart failure patients needing hospitalization. However, the improvements are not equally distributed across races/ethnicities and genders.

“Disparities in disease burden for males and especially African-Americans have not improved in the recent decade,” said lead author Boback Ziaeian, M.D., Ph.D., clinical instructor at the University of California Los Angeles and the U.S. Department of Veterans Affairs. “The findings highlight the need to address population-based health, prevention and outpatient management of chronic diseases.”

The authors note higher hospitalization burden among blacks and Hispanics is more reflective of underlying social determinants of health of health rather than genetics or physiologic differences.

The results should be met with caution as data collection had limitations.

Co-authors are Gerald F. Kominski, Ph.D., Michael K. Ong, M.D., Ph.D.., Vickie M.

Mays, Ph.D., Robert H. Brook, M.D., Sc.D. and Gregg C. Fonarow, M.D. Author disclosures are on the manuscript.

The National Institutes of Health partially funded the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: 214-706-1173

Akeem Ranmal: 214-706-1755; akeem.ranmal@heart.org  

For Public Inquiries: 800-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

 

]]>Heart NewsTue, 27 Jun 2017 20:00:08 GMTStudy Highlights: Heart failure hospitalizations in the United States have declined overall but remain significantly higher among blacks. While still hospitalized more than whites, the disparity narrowed between Hispanics and whites. Men were hospitalized more than women. http://newsroom.heart.org/news/hospitalizations-for-heart-failure-on-the-decline-disparities-remain-for-blacks-and-menTue, 27 Jun 2017 20:00:00 GMT

Only 1 in 5 patients seeking specialist for resistant HBP take meds as prescribed

AHA Stroke News - Tue, 06/27/2017 - 08:33
Study Highlights

  • Only one in five patients seeking specialty care for hard-to-control high blood pressure (resistant hypertension) are taking all their prescribed medications.
  • Taking all medication as prescribed can help avoid added tests and treatments based on the misperception that high blood pressure is not controlled despite taking multiple drugs.
  • A frank discussion about medication use and concerns about side effects can help your doctor make needed adjustments to get your blood pressure under control.

Embargoed 3 p.m. CT / 4 p.m. ET, Monday, March 6, 2017

DALLAS, March 6, 2017 – Only one in five patients seeking specialty care for hard-to-control high blood pressure (resistant hypertension) are taking all their prescribed medications, according to new research in the American Heart Association’s journal Hypertension.

“Another twenty percent are not taking any of their blood pressure medications,” said Peter Blankestijn, M.D., Ph.D., senior author of the study and professor of nephrology and hypertension at the University Medical Center Utrecht in the Netherlands. “People mistakenly thought to have resistant hypertension – which is high blood pressure despite taking three or more medications – end up seeing specialists and undergoing extra tests because we don’t understand why they are so difficult to treat.”

The surprising results come from a study designed primarily to determine if blood pressure can be lowered if people with resistant hypertension receive renal denervation, in addition to their blood pressure medication. In renal denervation, a slim tube (catheter) is inserted into one of the blood vessels in the groin and advanced through blood vessels until it enters the artery feeding the kidney; then, radio waves or ultrasound destroys sections of the nerves sending messages between the brain and the kidneys.

“There is much evidence to suggest that these nerves play a role in high blood pressure. In the 1930s and 1940s, the nerves were sometimes cut during surgical procedures. Now the nerve destruction can be done in a much less invasive way. Several devices are being studied as possible treatments for resistant hypertension,” Blankestijn said. “This study, one of the first to look in detail at patient compliance, found renal denervation as therapy for resistant hypertension was not superior to usual care.”

Researchers randomly assigned 95 patients (average age 62 years, 42.1 percent male) to undergo renal denervation while not changing their medication, while a control group of 44 patients (average age 60, 29.5 percent male) stayed with their usual medications alone. At the beginning of the study and 6 months later, patients wore a blood pressure monitor to calculate their average daytime systolic (top number) blood pressure and blood tests were taken to measure drug levels (without telling patients that their adherence in taking recommended medications was being assessed).

Researchers found:

  • 20 percent of patients were taking all their medication and 20 percent none of their medication,

  • 31 percent of patients either improved or lessened their medication compliance.

  • After six months, average daytime systolic blood pressure fell two points (mm Hg) more in control patients than in those who had renal denervation, but remained abnormally high in both groups.

  • Among patients with similar blood levels of medication at each assessment, systolic blood pressure fell 3.3 points more in those who received the procedure than in controls.

“Adherence to medication greatly affects the ability to assess the value of another treatment, so researchers need to measure adherence and do what they can to improve it,” Blankestijn said.

Patients can take steps to prevent their blood pressure from remaining high and being labeled as difficult-to-treat, leading to a greater heart disease risk and increased costs for added tests and treatments.

“At a minimum, be open and honest and tell your physician if you don’t want to take your pills for any reason. You and your doctor can discuss options for changing the type of pill or the dose if needed. There are many effective blood pressure pills and the majority of patients with high blood pressure can be successfully treated,” Blankestijn said.

Although this study was conducted in the Netherlands, the results likely apply to patients in the United States, according to researchers.

Co-authors are Rosa L. de Jager, M.D.; Esther de Beus, M.D.; Martine M.A. Beeftink, M.D.; Margreet G. Sanders, M.D., Evert-Jan Vonken, M.D.; Michiel Voskuil, M.D.; Erik M. van Maarseveen, Pharm.D.; and Michiel L. Bots, M.D. Author disclosures are on the manuscript.

The Netherlands Organization for Health Research and Development, the Dutch Kidney Foundation, and Medtronic Inc. supported the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content.  Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Bridgette McNeill: (214) 706-1135; bridgette.mcneill@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Heart NewsStroke NewsMon, 06 Mar 2017 21:00:15 GMTStudy Highlights: Only one in five patients seeking specialty care for hard-to-control high blood pressure (resistant hypertension) are taking all their prescribed medications. Taking all medication as prescribed can help avoid added tests and treatments based on the misperception that high blood pressure is not controlled despite taking multiple drugs. A frank discussion about medication use and concerns about side effects can help your doctor make needed adjustments to get your blood pressure under control. http://newsroom.heart.org/news/only-1-in-5-patients-seeking-specialist-for-resistant-hbp-take-meds-as-prescribedMon, 06 Mar 2017 21:00:00 GMT

More funding for heart disease research crucial for health of patients and the economy

AHA Heart News - Mon, 06/26/2017 - 15:07
Statement Highlights

  • By 2030, more than 40 percent of the U.S. population is projected to have heart failure or other forms of heart disease, with costs exceeding $1 trillion in healthcare expenditures and lost productivity.
  • Funding biomedical research is essential to the country’s health, but government and private funding is not keeping pace with need.

Embargoed until 3 p.m. CT / 4 p.m. ET Monday, June 26, 2017

DALLAS, June 26, 2017 — Biomedical research on heart disease produces a significant return on investment for both health and the economy, but government and private funding is not keeping pace with need, according to a new scientific statement published in the American Heart Association journal Circulation Research.

“For the last decade, biological research has been under siege owing to tightening budgets at the taxpayer funded National Institutes of Health and private funders,” said Joseph A. Hill, M.D., Ph.D. chair of the writing committee of the new scientific statement.

“Many people question the value of scientific research funded with taxpayer dollars, yet this research is essential to both our nation’s health and to our economy,” said Hill, who is also the James T. Willerson, M.D., distinguished chair in cardiovascular diseases at the University of Texas Southwestern Medical Center and the editor-in-chief of the American Heart Association journal Circulation.

For example, Hill pointed to the Women’s Health Initiative (WHI), which is estimated to have contributed to approximately 200,000 fewer cases of breast cancer and cardiovascular disease since its results were published in 2003. The initiative was funded by the National Institutes of Health.

In addition to the considerable health benefits from the WHI, the economic return from the $260 million program is estimated to be $37 billion in healthcare costs and work productivity, yielding a return on investment of $142 saved for every dollar spent.

While advances in treatments for heart disease over the last 50 years have led to a 75 percent decrease in deaths from heart attacks and other cardiovascular conditions, many people who previously would have died from a heart attack now leave the hospital with a damaged heart. This scenario frequently leads to heart failure, a chronic, progressive condition in which the heart muscle is unable to pump enough blood to maintain its workload.

“Beyond many benefits to individual and societal health, investments in research yield substantial economic returns in terms of jobs and tax revenues, products in the marketplace and for export, and skills that promote economic growth in other areas, which together ultimately “pay back” the money spent,” said Hill.

By 2030, more than 40 percent of the U.S. population is projected to have heart failure or other forms of heart disease, with costs exceeding $1 trillion in healthcare expenditures and lost productivity.

Discoveries that result from biomedical research lead to new insights into the underpinnings of disease, which in turn leads to new drug targets and the development of better drugs and improved diagnostic strategies.

Although scientific advances have dramatically prolonged the lives of people with heart disease, it remains the number one killer of men and women around the world and likely will continue into the future, Hill said.

Co-authors are Christine Seidman, M.D., vice-chair; Reza Ardehali, M.D., Ph.D.; Kimberli Taylor Clarke, M.D.; Gregory J. del Zoppo, M.D.; Lee L. Eckhardt, M.D.; Kathy K. Griendling, Ph.D.; Peter Libby, M.D.; Dan M. Roden, M.D.; Hesham A. Sadek, M.D.; and Douglas E. Vaughan, M.D.

Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter

For Media Inquiries: (214) 706-1173

Darcy Spitz: (212) 878-5940; Darcy.Spitz@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsMon, 26 Jun 2017 20:00:14 GMTStatement Highlights: By 2030, more than 40 percent of the U.S. population is projected to have heart failure or other forms of heart disease, with costs exceeding $1 trillion in healthcare expenditures and lost productivity. Funding biomedical research is essential to the country’s health, but government and private funding is not keeping pace with need. http://newsroom.heart.org/news/more-funding-for-heart-disease-research-crucial-for-health-of-patients-and-the-economyMon, 26 Jun 2017 20:00:00 GMT

African Americans with healthier lifestyles had lower risk of high blood pressure

AHA Heart News - Mon, 06/26/2017 - 15:07
Study Highlights

  • For every additional healthy behavior African Americans followed, there was a reduced risk for high blood pressure.
  • African Americans who followed 6 of the Life’s Simple 7 modifiable healthy behaviors had a 90 percent lower risk for high blood pressure than those who followed 0-1 of these behaviors.

Embargoed until 3 p.m. CT / 4 p.m. ET, Monday, June 26, 2017

DALLAS, June 26, 2017 – Among African Americans, small health improvements were associated with lower risk of developing high blood pressure, according to new research in the American Heart Association’s journal Hypertension. African Americans who had at least two modifiable healthy behaviors at the beginning of the study, compared to those with one or none, researchers found the risk of high blood pressure at follow-up was reduced by 20 percent.

Researchers also found that there was a 90 percent lower risk for high blood pressure among African Americans who had at least six of seven modifiable healthy behaviors that are defined as part of the American Heart Association’s Life’s Simple 7 compared with participants who followed none or one.

The Life’s Simple 7 was developed by the American Heart Association to monitor cardiovascular health in US adults and to help demonstrate that small changes can lead to a big impact in improving heart health. The Life’s Simple 7 includes: not smoking; maintaining a healthy weight; eating healthy; being physically active; maintaining healthy blood sugar levels; controlling cholesterol levels and managing blood pressure to reduce the risk of heart attack and stroke.

Compared with whites, African Americans have a greater risk for developing high blood pressure. According to the American Heart Association, currently one out of three adults in America has high blood pressure. Among non-Hispanic blacks, 45 percent of men and nearly half (46.3 percent) of women have high blood pressure.

“The Life’s Simple 7, an approach used by the American Heart Association to monitor cardiovascular health, can also be used to monitor high blood pressure risk in African Americans, a major risk factor for cardiovascular disease,” said John N. Booth, III, MS, lead study author and PhD student in the Department of Epidemiology at the University of Alabama at Birmingham. “We found that even small improvements in cardiovascular health can reduce risk for developing high blood pressure.”

These latest findings are based on the Jackson Heart Study, a community-based study designed to assess cardiovascular risk among African Americans. Blood pressure, blood sugar and cholesterol were measured in more than 5,000 study participants (5,306 total). They were also asked about their exercise, eating and smoking habits at the beginning of the study and followed up about 8 years later.

Among the study group researchers found:

  • More than half (50.3 percent) developed high blood pressure.
  • Eight out of 10 (81.3 percent) who followed only one or none of the healthy behaviors developed high blood pressure compared with only 1 in 10 (11.1 percent) of participants who followed six of the behaviors. None of the participants followed all seven healthy behaviors at the beginning of the study.

Overall, participants who followed more ideal health behaviors were younger and more likely to be women and to have at least a high school education and a household income of at least $25,000 a year.

Booth said that more research is needed to better understand why African Americans remain a population particularly vulnerable to high blood pressure, but that the Life’s Simple 7 program offers an opportunity to intervene and reduce their risk for additional heart health complications.

Co-authors are: John N. Booth III, MS; Paul Muntner, PhD Marwah Abdalla, MD, MPH; Rikki Tanner, PhD; Keith Diaz, PhD; Samantha Bromfield, PhD; Gabriel Tajeu, PhD; Adolfo Correa, MD, PhD; Mario Sims, PhD; Gbenga Ogedegbe, MD; Adam Bress, PharmD; Tanya Spruill, PhD; and Daichi Shimbo, MD;. Author disclosures are on the manuscript.

The Jackson Heart Study is funded by Jackson State University, Tougaloo College, and the University of Mississippi Medical Center contracts from the National Heart, Lung, and Blood Institute and the National Institute for Minority Health and Health Disparities.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.                                                                                                                      

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.                                                                                        

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Carrie Thacker: (214) 706-1665; carrie.thacker@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

 

]]>Heart NewsMon, 26 Jun 2017 20:00:09 GMTStudy Highlights: For every additional healthy behavior African Americans followed, there was a reduced risk for high blood pressure. African Americans who followed 6 of the Life’s Simple 7 modifiable healthy behaviors had a 90 percent lower risk for high blood pressure than those who followed 0-1 of these behaviors. http://newsroom.heart.org/news/african-americans-with-healthier-lifestyles-had-lower-risk-of-high-blood-pressureMon, 26 Jun 2017 20:00:00 GMT

Study: AHA Guidelines to Treating Patients with Coronary Artery Disease

AHA Heart News - Mon, 06/26/2017 - 10:03
DALLAS, Monday, June 26, 2017 – The most recent dual antiplatelet guidelines from the American Heart Association and the American College of Cardiology encourage healthcare providers to take a customized approach to treating patients with coronary artery disease. Healthcare providers can find out more about the latest best practices for using dual antiplatelet therapy by going to www.heart.org/amitoolkit.

The guidelines update recommendations in six previously published treatment guidelines, including those for bypass graft surgery, catheter-placed stents and myocardial infarction patients. The comprehensive new version reflects today’s best practices for using aspirin combined with P2Y12 receptor inhibitors clopidogrel, prasugrel or ticagrelor. It includes a review of 11 studies of patients treated with coronary stent implantation done predominately with drug-eluting stents, to assess the risks and benefits of shorter-versus longer-duration dual antiplatelet therapy.

“With drug-eluting stents, which represent one of the most common types of the stents used today, we have better outcomes, with lower risk of restenosis. But the downside is we have to use dual antiplatelet therapies for much longer,” said John A. Osborne, M.D., Ph.D., a cardiologist at State of the Heart Cardiology in Dallas.

Newer longer-term studies have helped to clarify optimal durations of dual antiplatelet therapy for specific patients, according to Osborne.

“One of the big questions among providers has been: What is the benefit, versus the harm, of long-term therapy?” said Osborne. “The guidelines suggest that longer term therapy may be reasonable for certain individuals, including those who are at lower risk of bleeding, because we are seeing further reduction of cardiovascular events with prolonged use of these drugs.”

Studies looking at prolonging dual antiplatelet therapy for an additional 18 or 48 months have found decreased risks of heart attack and stent thrombosis, but increased bleeding risk.

To get the best outcomes, providers must weigh the patient’s bleeding risk into the equation, according to Osborne.

The good news is that patients who are at generally lower risk of subsequent events but higher bleeding risk have fared well in studies looking at three to six months of dual antiplatelet therapy, compared with a standard 12 months of therapy. In appropriate patients, reducing the duration of dual antiplatelet therapy did not increase stent thrombosis risk and resulted in fewer bleeding complications.

The authors recommend shorter-duration dual antiplatelet therapy in patients treated with “newer-generation,” versus “first-generation,” drug-eluting stents.

The key for providers, according to Osborne, is individualization. For example, patients at higher than average cardiovascular risk, who appear to have a low bleeding risk,  benefit from not only continued efforts at risk factor modification but also may benefit from prolonged dual antiplatelet therapy treatment, he said. To help with those risk assessments, the guidelines provide lists of factors that increase clotting and heart attack risk, as well as increase bleeding risk.

The update also addresses such things as aspirin use, recommending most patients remain on a dose of 81 mg aspirin daily indefinitely after dual antiplatelet therapy.

It’s important for providers to take notice of the changes in the latest dual antiplatelet therapy update because the recommendations impact the quality of care for many among the roughly 16.5 million Americans with coronary heart disease.

“Guidelines always change according to the latest science. We want to make sure that providers are informed of the latest data, and how it ultimately will have the best impact for our patients,” Osborne said.

###

About the American Heart Association and American Stroke Association

The American Heart Association and the American Stroke Association are devoted to saving people from heart disease and stroke – America’s No. 1 and No. 5 killers. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based American Heart Association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. The American Stroke Association is a division of the American Heart Association. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries:

Alexson Calahan: (515) 994-0772; Alexson.Calahan@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsProgram NewsMon, 26 Jun 2017 14:38:50 GMTThe most recent dual antiplatelet guidelines from the American Heart Association and the American College of Cardiology encourage healthcare providers to take a customized approach to treating patients with coronary artery disease. Healthcare providers can find out more about the latest best practices for using dual antiplatelet therapy by going to www.heart.org/amitoolkit.http://newsroom.heart.org/news/study-aha-guidelines-to-treating-patients-with-coronary-artery-diseaseMon, 26 Jun 2017 13:00:00 GMT

Breastfeeding may reduce a mother’s heart attack and stroke risk

AHA Stroke News - Wed, 06/21/2017 - 15:31
Study Highlights

  • Breastfeeding is not only healthy for children, it may reduce a mother’s risk of having a heart attack or stroke later in life.
  • A study of Chinese women found that the longer a mother breastfeeds, the greater the cardiovascular health benefit appears to be.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, June 21, 2017

DALLAS, June 21, 2017 — Breastfeeding is not only healthy for babies, it may also reduce a mother’s risk of having a heart attack or stroke later in life, according to new research published in of the Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Previous studies have suggested that mothers get short-term health benefits from breastfeeding, such as weight loss and lower cholesterol, blood pressure and glucose levels after pregnancy. However, the long-term effects of breastfeeding on the risk of developing cardiovascular diseases in mothers are unclear. A new study in China found that women who breastfed their babies had about a ten percent lower risk of developing heart disease or stroke.

Researchers from the University of Oxford, the Chinese Academy of Medical Sciences and Peking University analyzed data from 289,573 Chinese women (average age 51) participating in the China Kadoorie Biobank study who provided detailed information about their reproductive history and other lifestyle factors. Nearly all were mothers and none had cardiovascular disease when they enrolled in the study. After eight years of follow-up, there were 16,671 cases of coronary heart disease, which includes heart attacks, and 23,983 stroke cases.

Researchers observed that:

  • Compared to women who had never breastfed, mothers who breastfed their babies had a 9 percent lower risk of heart disease and an 8 percent lower risk of stroke.
  • Among mothers who breastfed each of their babies for two years or more, heart disease risk was 18 percent lower and stroke risk was 17 percent lower than among mothers who never breastfed.
  • Each additional 6 months of breastfeeding per baby was associated with a 4 percent lower risk of heart disease and a 3 percent lower risk of stroke.

The researchers considered a range of risk factors for cardiovascular disease, including smoking, high blood pressure, obesity, diabetes and physical activity that could have biased results.

“Although we cannot establish the causal effects, the health benefits to the mother from breastfeeding may be explained by a faster “reset” of the mother’s metabolism after pregnancy. Pregnancy changes a woman’s metabolism dramatically as she stores fat to provide the energy necessary for her baby’s growth and for breastfeeding once the baby is born. Breastfeeding could eliminate the stored fat faster and more completely,” said co-author, Sanne Peters, Ph.D., a research fellow at the University of Oxford in the United Kingdom.

The authors noted that women who breastfeed may be more likely to engage in other beneficial health behaviors that lower their risk of cardiovascular disease compared to women who do not breastfeed.

Because this study was observational, relying on information provided by the mothers about their breastfeeding histories, it does not prove cause and effect. Results from observational studies such as this one must be confirmed by a different type of study that can prove that a behavior may results in an outcome.

Compared to women in China, breastfeeding duration is typically shorter among women in the United States. Ninety-seven percent of the women in this study breastfed each of their babies for an average of 12 months, compared to 30 percent of U.S. mothers in 2016, according to the World Health Organization. However, the U.S. Nurses’ Health Study found only women with a lifetime duration of breastfeeding of 2 years or more had a significantly lower risk of coronary heart disease than those who never breastfed. 

 “The findings should encourage more widespread breastfeeding for the benefit of the mother as well as the child,” said Zhengming Chen, M.B.B.S., D.Phil., senior study author and professor of epidemiology at the University of Oxford. “The study provides support for the World Health Organization’s recommendation that mothers should breastfeed their babies exclusively for their first six months of life.”

The American Heart Association suggests breastfeeding for 12 months if possible.

Co-authors are Ling Yang, Ph.D.; Yu Guo, M.Sc.; Yiping Chen, D.Phil.; Zheng Bian, M.Sc.; Jianwei Du, M.D.; Jie Yang, MSc.; Shanpeng Li, M.Sc.; Liming Li, M.P.H. and Mark Woodward, Ph.D. Author disclosures are on the manuscript.

The Kadoorie Charitable Foundation, Hong Kong; UK Wellcome Trust; Chinese Ministry of Science and Technology; Chinese National Natural Science Foundation; The British Heart Foundation; UK Medical Research Council; Cancer Research UK; National Natural Science Foundation of China and British Heart Foundation funded the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Darcy Spitz: (212) 878-5940 ; darcy.spitz@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsStroke NewsWed, 21 Jun 2017 20:00:07 GMTBreastfeeding is not only healthy for children, it may reduce a mother’s risk of having a heart attack or stroke later in life. A study of Chinese women found that the longer a mother breastfeeds, the greater the cardiovascular health benefit appears to be. http://newsroom.heart.org/news/breastfeeding-may-reduce-a-mothers-heart-attack-and-stroke-riskWed, 21 Jun 2017 20:00:00 GMT

Breastfeeding may reduce a mother’s heart attack and stroke risk

AHA Heart News - Wed, 06/21/2017 - 15:31
Study Highlights

  • Breastfeeding is not only healthy for children, it may reduce a mother’s risk of having a heart attack or stroke later in life.
  • A study of Chinese women found that the longer a mother breastfeeds, the greater the cardiovascular health benefit appears to be.

Embargoed until 3 p.m. CT / 4 p.m. ET Wednesday, June 21, 2017

DALLAS, June 21, 2017 — Breastfeeding is not only healthy for babies, it may also reduce a mother’s risk of having a heart attack or stroke later in life, according to new research published in of the Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Previous studies have suggested that mothers get short-term health benefits from breastfeeding, such as weight loss and lower cholesterol, blood pressure and glucose levels after pregnancy. However, the long-term effects of breastfeeding on the risk of developing cardiovascular diseases in mothers are unclear. A new study in China found that women who breastfed their babies had about a ten percent lower risk of developing heart disease or stroke.

Researchers from the University of Oxford, the Chinese Academy of Medical Sciences and Peking University analyzed data from 289,573 Chinese women (average age 51) participating in the China Kadoorie Biobank study who provided detailed information about their reproductive history and other lifestyle factors. Nearly all were mothers and none had cardiovascular disease when they enrolled in the study. After eight years of follow-up, there were 16,671 cases of coronary heart disease, which includes heart attacks, and 23,983 stroke cases.

Researchers observed that:

  • Compared to women who had never breastfed, mothers who breastfed their babies had a 9 percent lower risk of heart disease and an 8 percent lower risk of stroke.
  • Among mothers who breastfed each of their babies for two years or more, heart disease risk was 18 percent lower and stroke risk was 17 percent lower than among mothers who never breastfed.
  • Each additional 6 months of breastfeeding per baby was associated with a 4 percent lower risk of heart disease and a 3 percent lower risk of stroke.

The researchers considered a range of risk factors for cardiovascular disease, including smoking, high blood pressure, obesity, diabetes and physical activity that could have biased results.

“Although we cannot establish the causal effects, the health benefits to the mother from breastfeeding may be explained by a faster “reset” of the mother’s metabolism after pregnancy. Pregnancy changes a woman’s metabolism dramatically as she stores fat to provide the energy necessary for her baby’s growth and for breastfeeding once the baby is born. Breastfeeding could eliminate the stored fat faster and more completely,” said co-author, Sanne Peters, Ph.D., a research fellow at the University of Oxford in the United Kingdom.

The authors noted that women who breastfeed may be more likely to engage in other beneficial health behaviors that lower their risk of cardiovascular disease compared to women who do not breastfeed.

Because this study was observational, relying on information provided by the mothers about their breastfeeding histories, it does not prove cause and effect. Results from observational studies such as this one must be confirmed by a different type of study that can prove that a behavior may results in an outcome.

Compared to women in China, breastfeeding duration is typically shorter among women in the United States. Ninety-seven percent of the women in this study breastfed each of their babies for an average of 12 months, compared to 30 percent of U.S. mothers in 2016, according to the World Health Organization. However, the U.S. Nurses’ Health Study found only women with a lifetime duration of breastfeeding of 2 years or more had a significantly lower risk of coronary heart disease than those who never breastfed. 

 “The findings should encourage more widespread breastfeeding for the benefit of the mother as well as the child,” said Zhengming Chen, M.B.B.S., D.Phil., senior study author and professor of epidemiology at the University of Oxford. “The study provides support for the World Health Organization’s recommendation that mothers should breastfeed their babies exclusively for their first six months of life.”

The American Heart Association suggests breastfeeding for 12 months if possible.

Co-authors are Ling Yang, Ph.D.; Yu Guo, M.Sc.; Yiping Chen, D.Phil.; Zheng Bian, M.Sc.; Jianwei Du, M.D.; Jie Yang, MSc.; Shanpeng Li, M.Sc.; Liming Li, M.P.H. and Mark Woodward, Ph.D. Author disclosures are on the manuscript.

The Kadoorie Charitable Foundation, Hong Kong; UK Wellcome Trust; Chinese Ministry of Science and Technology; Chinese National Natural Science Foundation; The British Heart Foundation; UK Medical Research Council; Cancer Research UK; National Natural Science Foundation of China and British Heart Foundation funded the study.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Darcy Spitz: (212) 878-5940 ; darcy.spitz@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsStroke NewsWed, 21 Jun 2017 20:00:07 GMTBreastfeeding is not only healthy for children, it may reduce a mother’s risk of having a heart attack or stroke later in life. A study of Chinese women found that the longer a mother breastfeeds, the greater the cardiovascular health benefit appears to be. http://newsroom.heart.org/news/breastfeeding-may-reduce-a-mothers-heart-attack-and-stroke-riskWed, 21 Jun 2017 20:00:00 GMT

Healthcare providers should individualize patient education

AHA Heart News - Mon, 06/19/2017 - 15:29
Statement Highlight

  • Health information should be tailored to a patient’s ability to understand health concepts and keep them motivated to maintain long-term changes.

Embargoed until 3 p.m. CT / 4 p.m. ET Monday, June 19, 2017

DALLAS, June 19, 2017 — Effective patient education includes more than brochures and written patient information. It should be tailored to a patient’s ability to understand recommendations to help them manage their health and control their risk factors, according to an American Heart Association scientific statement published in the Association’s journal Circulation: Cardiovascular Quality and Outcomes.

The statement encourages healthcare professionals to use a multi-faceted approach to help patients and their families learn healthy habits after a heart attack or if they have high blood pressure, atrial fibrillation or heart failure.

“As hospital stays and clinic visits get shorter, the responsibility for patient management has increasingly shifted to patients and their families,” said Susan Barnason, Ph.D., R.N., lead author of the statement and professor of nursing practice at the University of Nebraska Medical Center in Lincoln.

“Patient education can’t be one-size-fits-all. It needs to meet the patients where they are, so clinicians need to assess their patients’ health literacy and cognitive skills, and include family and other caregivers when needed,” Barnason said.

The statement recommends a collaborative approach between healthcare providers, the patient and their family. For example, a regular follow-up call from a nurse could be helpful for a patient struggling to make healthy lifestyle choices. Registered dieticians or health coaches can help patients solve barriers to healthy lifestyle changes. Nurses can provide brief self-management support and training for patients in regular medical visits. 

“Tell your provider if you don’t understand your condition or you are unclear about the plan to help you manage it. Your physician may schedule an extended or follow-up visit, or may ask the nurse to answer your immediate questions,” Barnason said.

Technological advances, such as such as apps that allow people to measure and monitor blood pressure or track and remind them to take their medication, may make it easier and more engaging for patients to monitor their health and communicate the results with their healthcare providers.

“We can’t make you take your pills or check your blood pressure or blood sugar. Some of the new technologies help it become more real – instead of just putting numbers on a piece of paper you can see the trends and get a better picture of how you’re doing.” Barnason said.

Co-authors are co-chair of the writing committee Connie White-Williams, Ph.D., R.N., F.N.P.; Laura P. Rossi, Ph.D., R.N.; Mae Centeno, D.N.P., R.N., C.C.N.S., A.C.N.S.-B.C.; Deborah L. Crabbe, M.D.; Kyoung Suk Lee, Ph.D., R.N., M.P.H.; Nancy McCabe, Ph.D., R.N.; Julie Nauser, Ph.D., R.N.; Paula Schulz, Ph.D., R.N.; Kelly Stamp, Ph.D., R.N., A.P.N.-C. and Kathryn Wood, Ph.D., R.N. on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, and Stroke Council. Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries: (214) 706-1173

Darcy Spitz: (212) 878-5940; Darcy.Spitz@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsMon, 19 Jun 2017 20:00:08 GMTStatement Highlight: Health information should be tailored to a patient’s ability to understand health concepts and keep them motivated to maintain long-term changes. http://newsroom.heart.org/news/healthcare-providers-should-individualize-patient-educationMon, 19 Jun 2017 20:00:00 GMT

ISC17 FRIDAY NEWS TIP

AHA Stroke News - Fri, 06/16/2017 - 12:23
Embargoed for 9:33 a.m. CT/10:33 a.m. ET – Session A33 — Abstract 222

Regular aerobic exercise beginning in middle age may lessen severity of stroke in old age

The network of blood vessels (collateral circulation) shrinks in number and diameter as the brain ages. Collateral circulation allows blood flow to be rerouted when arteries narrow. Using mice, researchers found that this loss of collateral vessels is prevented by exercise, according to a study presented at the American Heart Association’s International Stroke Conference 2017.

The amount of damage to the brain after a stroke and the effectiveness of recovery treatments depend significantly on the extent of collateral circulation.

Mice that started exercising regularly at twelve months-age (equivalent to 40 years-age in humans) had the same abundance of collateral vessels when they reached 25 months-age (equivalent to 70 humans years) as seen at 3 months-age (equivalent to 16 human years), unlike their non-exercising 25-month-old counterparts who had fewer collaterals of smaller diameter. When the exercising 25-month-old mice suffered strokes, they had much less brain damage, i.e., the same as seen in young 3-month-old mice. The exercising mice also had higher levels of molecules that help blood vessels work properly and stay healthy.

Researchers said their findings suggest that regular aerobic exercise may protect the collateral circulation and lessen the severity of strokes later in life.

James E. Faber Ph.D., University of North Carolina, Chapel Hill, North Carolina; Wojciech J. Rzechorzek, M.D., University of North Carolina, Carrboro, North Carolina.

Additional Resources:

###

Statements and conclusions of study authors that are presented at American Stroke Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing the science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

For Media Inquiries and ASA Spokesperson Perspective:

AHA/ASA News Media in Dallas: (214) 706-1173

AHA/ASA News Media Office, Feb. 21-24,

at the George R. Brown Convention Center: (713) 853-8406

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Stroke NewsScientific Conferences & MeetingsWed, 08 Mar 2017 15:31:22 GMTEmbargoed for 9:33 a.m. CT/10:33 a.m. ET – Session A33 — Abstract 222 Regular aerobic exercise beginning in middle age may lessen severity of stroke in old age The network of blood vessels (collateral circulation) shrinks in number and diameter as the...http://newsroom.heart.org/news/isc17-friday-news-tipFri, 24 Feb 2017 15:33:00 GMT

Psychiatric illness may increase stroke risk

AHA Stroke News - Fri, 06/16/2017 - 09:20
Study Highlights: 

  • Short-term stroke risk appears higher in patients hospitalized or treated in the emergency room for psychiatric illness.
  • Risk of stroke was greatest within 15 days of psychiatric diagnosis, declined with time, but persists for at least a year.
  • Healthcare professionals should listen carefully for signs of psychological distress in patients at risk of stroke.

Embargoed until 3 p.m. CT/4 p.m. ET, Thursday, Feb. 23, 2017

HOUSTON, Feb. 23, 2017 – Patients hospitalized or treated in the emergency room for depression, anxiety, posttraumatic stress disorder (PTSD) or other psychiatric disorders may have an increased risk for stroke, particularly in the 15 days following their psychiatric diagnosis, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

“Based on my clinical experience in the hospital, I have noticed that many patients believe that stress for whatever reason — work, family, work-life balance — contributed to their stroke,” said Jonah P. Zuflacht, B.A., lead researcher and a fourth-year medical student at Columbia University’s College of Physicians and Surgeons in New York. “But the data to support a connection between stress and stroke is limited and often relies on a patient’s subjective recall of distress, which can bias results.”

Researchers analyzed the Healthcare Cost and Utilization Project database for California and found 52,068 stroke patients between 2007-2009. Of these patients, 3,337 patients were hospitalized or treated in the emergency room for depression, anxiety, PTSD or another psychiatric disorder. Using a case-crossover analysis, researchers found that psychiatric distress leading to a hospital visit increased the odds of stroke within five time periods. The odds of a stroke were:

  • 3.48 times higher within 15 days;
  • 3.11 times higher within 30 days;
  • 2.41 times higher within 90 days;
  • 2.23 times higher within 180 days; and
  • 2.61 times higher within 360 days.

Zuflacht said there are several possible explanations for the study findings. Psychological distress may send the body’s fight-or-flight response into overdrive, causing increased blood pressure — the No. 1 risk factor for stroke. Psychologic distress may also cause changes within cells that trigger inflammation and oxidative stress, both of which are thought to increase stroke risk. Another possible explanation for the study findings, he said, is that when people experience psychological distress, they may forget to take medicines prescribed to reduce their risk of stroke.

“Healthcare professionals should listen to their patients for symptoms of psychiatric illness, especially in those who may be at increased risk of stroke,” Zuflacht said. “A patient with high blood pressure, high cholesterol and six months of depressive symptoms should raise concerns regarding possible stroke risk.”

Detailed information about each patient was lacking, which might suggest other factors that increased stroke risk or provide insight into which psychiatric conditions had a stronger association with stroke than others. Researchers also did not include data on psychiatric conditions from outpatient settings in their study.

According to the American Heart Association’s Heart Disease and Stroke Statistical Update, 795,000 Americans have a stroke every year, causing 129,000 deaths, and stroke is the leading cause of disability in the country.

Co-authors are: Yuefan Shao; Mitchell S.V. Elkind, M.D., M.S.; Hooman Kamel, M.D.; Amelia K. Boehme, Ph.D., M.S.P.H.; and Joshua Willey, M.D., M.S. Author disclosures are on the abstract.

Additional Resources:

###

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

Note: Actual presentation is 5:25 p.m. CT/4:25 p.m. ET Thursday, Feb. 23, 2017 in Hall E.

For Media Inquiries and ASA Spokesperson Perspective:

AHA/ASA News Media in Dallas: (214) 706-1173

AHA/ASA News Media Office, Feb. 21-24,

at the George R. Brown Convention Center: (713) 853-8406

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . .we help people live longer, healthier lives.

]]>Scientific Conferences & MeetingsStroke NewsWed, 08 Mar 2017 15:37:14 GMTStudy Highlights:  Short-term stroke risk appears higher in patients hospitalized or treated in the emergency room for psychiatric illness. Risk of stroke was greatest within 15 days of psychiatric diagnosis, declined with time, but persists for at least a year. Healthcare professionals should listen carefully for signs of psychological distress in patients at risk of stroke. http://newsroom.heart.org/news/psychiatric-illness-may-increase-stroke-riskThu, 23 Feb 2017 21:00:00 GMT

ISC17 THURSDAY NEWS TIPS

AHA Stroke News - Fri, 06/16/2017 - 09:20
Tip Headlines:

  • Epilepsy in the elderly linked to increased stroke risk
  • E-cigarettes may pose the same or higher risk of stroke severity as tobacco smoke
  • Biological, not chronological age, better predictor of stroke recovery
  • Parkinson’s disease may have link to stroke
  • Inadequate access to affordable, nutritious food may increase stroke risk factors
  • Symptoms of depression in stroke survivors may predict caregiver depression
  • Men more likely than women to get “ultrafast” stroke treatment
  • Military single-payer health system free of stroke care racial disparity, but rank matters
  • Children more vulnerable to psychological problems after a stroke

Note: All Times are Central (CT). All tips are embargoed until the time of presentation or 3 p.m. CT/4 p.m. ET each day, whichever comes first.

Embargoed for 9:57 a.m. CT/10:57 a.m. ET – Session A20 – Abstract 140

Epilepsy in the elderly linked to increased ischemic stroke risk

Elderly patients with seizures have an increased risk of future stroke, but not heart attack, when compared to those without seizures, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Researchers analyzed inpatient and outpatient claims data on 1,548,556 Medicare beneficiaries ages 66 and older. One percent (15,055 people) developed epilepsy and nearly 8 percent (121,866 people) had an ischemic (clot-caused) stroke or heart attack during an average follow-up of 4.4 years.

Researchers found:

  • After statistically adjusting for established stroke and heart attack risk factors, epilepsy was associated with a 77 percent increased risk of stroke.
  • On average, patients with seizures were older and were more likely to have other types of vascular disease.
  • Epilepsy was not independently associated with an increased risk of heart attack.

The study suggests that epilepsy in the elderly might signify disease of blood vessels in the brain, but not necessarily diseased vessels elsewhere in the body, researchers said.

Matthew Mercuri, M.D., Weill Cornell Medicine, New York City, New York.

 

Embargoed for 1:42 p.m. CT/2:42 p.m. ET – Session A25 – Abstract LB10 in Grand Ballroom B

E- cigarettes may pose the same or higher risk of stroke severity as tobacco smoke

 NOTE - On Feb. 24 - the e-cigarette tip was updated to correct the third bullet point, per researcher.

Electronic cigarette (e-cigarettes) vaping may pose just as much or even higher risk as smoking tobacco for worsening a stroke, according to a preliminary study in mice presented at the American Heart Association’s International Stroke Conference 2017.

Researchers found:

  • Mice exposed to e-cigarette vapor for 10 days or 30 days had worse stroke outcome and neurological deficits, than those exposed to tobacco smoke.
  • E-cigarette exposure decreased glucose uptake in the brain. Glucose fuels brain activity.
  • Both e-Cig and tobacco smoke exposure for 30 days decreased Thrombomodulin (anti-coagulant) levels. 

From a brain health perspective, researchers said, electronic-cigarette vaping is not safer than tobacco smoking, and may pose a similar, if not higher risk for stroke severity.

Use of e-cigarettes is a growing health concern in both smoking and nonsmoking populations. Researchers said rigorous studies are needed to investigate the effects of the nicotine exposure via e-cigarettes on brain and stroke outcome.

Ali Ehsan Sifat, Graduate Student/Research Assistant, Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, Texas.

 

Embargoed for 2:30 p.m. CT/3:30 p.m. ET – Session A23 – Abstract 160

Biological, not chronological age, better predictor of stroke recovery

Biological age and not chronological age may help predict a patient’s recovery three months after a stroke, according to a preliminary study presented at the American Heart Association’s International Stroke Conference 2017.

Age is considered an important predictor of the severity of a stroke, but the chronological number is not the only way to measure age.

Researchers analyzed 600 adults with ischemic stroke (clot-caused stroke) who were assessed in Hospital del Mar in Barcelona. Biological age was estimated by analyzing a particular characteristic in DNA molecules that change over time (degree of methylation at 71 specific sites throughout the genome of the individual).

Researchers found DNA structure changes as a person gets older, so the extent of change can be used as an estimate of biological age. Other indicators that may also predict a patient’s recovery are neurological status at admission, degree of changes in mobility after stroke, and promptness of the restoration of blood flow in the brain.

The findings suggest biological age is an important factor in a patient’s recovery after stroke and better stroke recovery is another benefit of healthy aging, researchers said.

Jordi Jimenez-Conde, M.D., Ph.D., Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.

 

Embargoed for 3 p.m. CT/4 p.m. ET –  Session P25 – Poster TP165

Parkinson’s disease may have link to stroke

Parkinson’s disease may be linked to stroke, much like Alzheimer’s disease and stroke are linked, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

To see if an association exists between stroke and Parkinson’s disease, a common neurodegenerative condition, researchers studied medical claims information from 2008 to 2014 in a sample of Medicare beneficiaries, aged 66 years and older. In separate analyses, they also studied the relationship between stroke and Alzheimer’s disease for comparison.

In their analysis of 1.6 million patients, researchers found:

  • The annual incidence of ischemic (clot caused) stroke was 1.75 percent among those diagnosed with Parkinson’s compared to 0.96 percent in those without Parkinson’s.
  • In contrast, the annual incidence of ischemic stroke was 1.96 percent among those diagnosed with Alzheimer’s disease, versus 0.96 percent in those without Alzheimer’s.
  • The annual incidence of Parkinson’s disease was 0.97 percent after ischemic stroke versus 0.39 percent in those without ischemic stroke.
  • In contrast, the annual incidence of Alzheimer’s was 3.66 percent in elderly adults diagnosed with stroke, versus 1.17 percent in those without ischemic stroke.

Among Medicare beneficiaries, the relationships between stroke and Parkinson’s disease were similar to those between stroke and Alzheimer’s disease, researcher said.

Benjamin R. Kummer, M.D., Weill Cornell Medical College, New York, N.Y.

Note: Actual presentation is 6:15 p.m. CT/7:15 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

 

Embargoed for 3 p.m. CT/4 p.m. ET – Session P25 – Poster TP183

Inadequate access to affordable, nutritious food may increase stroke risk factors

Food insecurity – the state of being without reliable access to adequate amounts of affordable, nutritious food – is a common issue and may lead to increased stroke risk factors, such as diabetes and high blood pressure, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Researchers at a Chicago hospital that serves uninsured and underinsured patients studied 216 patients in the outpatient neurology clinic. Using a standardized two-question screening tool and reviewing electronic medical records, researchers identified 49 patients, or 22.7 percent, as food insecure.

Researchers also found:

  • Of the 64 patients diagnosed with stroke, 18.8 percent were found to be food insecure.
  • In the food insecure stroke group, 84.6 percent also had hypertension; 58.3 percent diabetes; and 16.7 percent had a previous stroke.
  • Among stroke survivors not labelled food insecure, 67.3 percent had hypertension; 28.8 percent had diabetes; and 21.2 percent had a previous stroke.

Food insecurity may lead to an increase in stroke risk factors and can complicate management of these health problems. A better understanding of the magnitude of the problem is necessary and could lead to interventions, researchers said.

Lakshmi Warrior, M.D., John H. Stroger Hospital of Cook County, Chicago, Illinois may be reached through Alexandra Normington, Director of Media at Cook County Health & Hospitals System.

Note: Actual presentation is 6:15 p.m. CT/7:15 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

 

Embargoed for 3 p.m. CT/4 p.m. ET – Session MP14 – Poster TMP49

Symptoms of depression in stroke survivors may predict caregiver depression

Stroke survivors’ depressive symptoms predict caregivers’ depressive symptoms, but caregivers’ well-being does not predict stroke survivors’ depression or quality of life, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Researchers studied interviews of 248 stroke survivors and their primary caregivers at 9-, 18-, 27- and 36-months after the survivors’ strokes.

They found:

  • Seventeen percent of stroke survivors and 13.7 percent of caregivers had clinically significant levels of depressive symptoms at nine months.
  • The measurements revealed that high stroke survivor depressive symptoms at nine-months post-stroke predicted increases in caregiver depressive symptoms at 18-months post-stroke.
  • There were no predictive effects, over time, for caregivers’ depressive symptoms on stroke survivors’ depression or health-related quality of life.

Treating elevated depressive symptoms in stroke survivors may also improve caregiver well-being, researchers said.

David L. Roth, Ph.D., Johns Hopkins University, Baltimore, Maryland.

Note: Actual presentation is 6:10 p.m. CT/7:10 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

 

Embargoed for 3 p.m. CT/4 p.m. ET – Session MP18 – Poster TMP88

Men more likely than women to get “ultrafast” stroke treatment

Male stroke patients are twice as likely as female patients to get clot-busting stroke treatment less than 30 minutes after hospital arrival, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

The benefits of treating acute ischemic (clot-caused) stroke patients with intravenous tissue-type plasminogen activator (tPA) are time dependent. AHA/ASA guidelines recommend that acute ischemic stroke patients get the clot-busting treatment within 60 minutes of hospital arrival, which is called door-to-needle time. Still, researchers suggest that with every 15-minute reduction in treatment time, patients’ health results improve by an estimated 4 percent.

In this study, researchers identified characteristics of patients with treatment times of less than 30 minutes, called ultrafast door-to-needle times. They studied stroke patient information from a 26-hospital health system and found:

  • from 2009 to 2015, 2,695 acute ischemic stroke patients received tPA;
  • of those, 3.9 percent, had ultrafast door-to-needle times; and
  • ultrafast door-to-needle time patients were more than twice as likely to be male, more than four-times as likely to arrive by ambulance, and nearly twice as likely to arrive on a weekday.

The study suggests that only a small percentage of these stroke patients receive ultrafast treatment and highlights the need to better understand the role gender plays in treatment-related decisions, researchers said.

Archit Bhatt, M.D., M.P.H., Providence Brain and Spine Institute, Portland, Oregan.

Note: Actual presentation is 5:25 p.m. CT/6:25 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

 

Embargoed for 3 p.m. CT/4 p.m. ET – Session MP17 – Poster TMP79

Military single-payer health system free of stroke care racial disparity, but rank matters

Racial disparity in the care of stroke patients, which exists in the civilian U.S. healthcare system, does not appear to exist in the U.S. military healthcare system, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

However, they noted better outcomes after stroke for those in higher ranks versus lower ranks.

Researchers studied stroke outcomes, or results, among stroke survivors in the single-payer U.S. military healthcare system, in which every member has the same health benefits. They collected information from 2010 to 2015 on 3,623 patients admitted to military care facilities and discharged with the diagnosis of stroke. They studied race and rank.

They found no correlation between race and total cost of hospitalization or outcome. However, they did find a “statistically significant trend” toward better outcomes after stroke for those in higher ranks versus lower ranks.

Matthew Holtkamp, D.O., Carl R. Darnell Army Medical Center, Harker Heights, Texas.

Note: Actual presentation is 5:40 p.m. CT/6:40 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

 

Embargoed for 3 p.m. CT/4 p.m. ET – Session P33 – Poster TP405

Children more vulnerable to psychological problems after a stroke

Children who have suffered ischemic (clot-caused) strokes are more likely to have psychological problems, including anxiety and behavioral difficulties, than children who have not had a stroke, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Researchers studied 50 children who had suffered an ischemic stroke at a range of ages – from one month to about 17 years. Parents completed a behavioral checklist at least 10 months after their child’s stroke.

Researchers found:

  • Children with stroke had notably greater mood, anxiety, somatic (physical), oppositional defiance and conduct problems than children without stroke.
  • Children who had strokes at ages younger than six years had notably higher anxiety levels than older children who had stroke. That could be due to changes in family dynamics when young children suffer a neurological injury, researchers said.

“These results support the need for careful psychological follow-up in this vulnerable population,” researchers said.

Emily Maxwell, Ph.D., University of Colorado School of Medicine, Aurora, Colorado.

Note: Actual presentation is 6:15 p.m. CT/7:15 p.m. ET, Thursday, Feb. 23, 2017 in Hall E.

Additional Resources:

###

Statements and conclusions of study authors that are presented at American Stroke Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing the science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

For Media Inquiries and ASA Spokesperson Perspective:

AHA/ASA News Media in Dallas: (214) 706-1173

AHA/ASA News Media Office, Feb. 21-24,

at the George R. Brown Convention Center: (713) 853-8406

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Stroke NewsScientific Conferences & MeetingsFri, 24 Feb 2017 17:28:40 GMTTip Headlines: Epilepsy in the elderly linked to increased stroke risk; E-cigarettes may pose the same or higher risk of stroke severity as tobacco smoke; Biological, not chronological age, better predictor of stroke recovery; Parkinson’s disease may have link to stroke; Inadequate access to affordable, nutritious food may increase stroke risk factors; Symptoms of depression in stroke survivors may predict caregiver depression; Men more likely than women to get “ultrafast” stroke treatment; Military single-payer health system free of stroke care racial disparity, but rank matters; Children more vulnerable to psychological problems after a stroke. http://newsroom.heart.org/news/isc17-thursday-news-tipsThu, 23 Feb 2017 21:00:00 GMT

Horse, rhythm-and-music therapies may boost recovery after stroke

AHA Stroke News - Thu, 06/15/2017 - 15:19
Study Highlights

  • Horseback riding and rhythm-and-music therapies may improve balance, gait, cognition and long-term perception of recovery for stroke survivor’s years after their stroke.
  • Researchers said significant improvements are still possible years after stroke using motivating, comprehensive therapies that combine physical, sensory, cognitive and social components to stimulate and increase brain activity.

Embargoed until 3 p.m. CT / 4 p.m. ET Thursday, June 15, 2017

DALLAS, June 15, 2017 — Horseback riding and rhythm-and-music therapies may improve stroke survivors’ perception of recovery, gait, balance, grip strength and cognition years after their stroke, according to new research in the American Heart Association’s journal Stroke.

A variety of interventions that engage patients in physical, sensory, cognitive and social activities simultaneously target a range of functions. Researchers said this combination of different activities and stimuli, rather than the individual components, appear to produce additional beneficial effects for stroke recovery.

“Significant improvements are still possible, even years after a stroke, using motivating, comprehensive therapies provided in stimulating physical and social surroundings to increase brain activity and recovery,” said Michael Nilsson, M.D., Ph.D. senior author and Director of the Hunter Medical Research Institute and Professor at the University of Newcastle in Australia and University of Gothenburg, Sweden.

Researchers studied 123 Swedish men and women (age 50-75) who had suffered strokes between 10 months and 5 years earlier. Survivors were randomly assigned to rhythm-and-music therapy, horse-riding therapy or ordinary care (the control group). The therapies were given twice a week for 12 weeks.

Researchers found that among the survivors who felt they experienced an increased perception of recovery:

  • 56 percent were in the horse-riding group;
  • 38 percent in the rhythm and music group; and
  • 17 percent in the “control or usual care” group.

The perception of recovery was sustained at three-month and six-month follow-ups.

Horse-riding therapy produces a multisensory environment and the three-dimensional movements of the horse’s back create a sensory experience that closely resembles normal human gait and is beneficial for stroke survivors.

In rhythm-and-music therapy patients listen to music while performing rhythmic and cognitively demanding hand and feet movements to visual and audio cues. Researchers found that the rhythm-and-music activity helped survivors with balance, grip-strength and working memory.

Limitations of the study include the relatively small number of participants and survivors with severe disabilities could not be considered for the therapy. In addition, researchers doubt these therapies would be cost-effective if patients with mild deficiencies had been included.

Further analyses of the study results and follow-up studies involving more participants are planned to help determine efficiency, timing and costs.

Co-authors are Lina Bunketorp-Käll, Ph.D.; Åsa Lundgren-Nilsson, Ph.D.; Hans Samuelsson, Ph.D.; Tulen Pekny, M.D.; Karin Blomvé, M.D.; Marcela Pekna, M.D., Ph.D.; Milos Pekny, M.D., Ph.D.; and Christian Blomstrand, M.D., Ph.D. Author disclosures and funding are on the manuscript.

Additional Resources:

###

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Karen Astle: (214) 706-1392; karen.astle@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Heart NewsStroke NewsThu, 15 Jun 2017 20:00:07 GMTStudy Highlights: Horseback riding and rhythm-and-music therapies may improve balance, gait, cognition and long-term perception of recovery for stroke survivor’s years after their stroke. Researchers said significant improvements are still possible years after stroke using motivating, comprehensive therapies that combine physical, sensory, cognitive and social components to stimulate and increase brain activity. http://newsroom.heart.org/news/horse-rhythm-and-music-therapies-may-boost-recovery-after-strokeThu, 15 Jun 2017 20:00:00 GMT

Replacing saturated fat with healthier fat may lower cholesterol as well as drugs in context of a healthy diet

AHA Heart News - Thu, 06/15/2017 - 15:19
Highlights

  • Scientific studies that lowered intake of saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent; similar to cholesterol-lowering drugs, known as statins.
  • Several studies found that coconut oil – which is predominantly saturated fat and widely touted as healthy – raised LDL cholesterol the same way as other saturated fats found in butter, beef fat and palm oil.

Embargoed until 3 p.m. CT / 4 p.m. ET Thursday, June 15, 2017  

DALLAS, June 17, 2017 – The American Heart Association continues to recommend replacing saturated fats with poly- and mono-unsaturated vegetable oil to help prevent heart disease, according to a new American Heart Association advisory, published in the association’s journal Circulation.

Periodically, the evidence supporting limiting saturated fats has been questioned in scientific literature and the popular press. This advisory was commissioned to review the current evidence and explain the scientific framework behind the American Heart Association’s long-standing recommendation to limit foods high in saturated fats. 

“We want to set the record straight on why well-conducted scientific research overwhelmingly supports limiting saturated fat in the diet to prevent diseases of the heart and blood vessels,” said Frank Sacks, M.D., lead author of the advisory and professor of Cardiovascular Disease Prevention at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts. “Saturated fat increases LDL – bad cholesterol – which is a major cause of artery-clogging plaque and cardiovascular disease.”

Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut, palm and others. Other types of fats include poly-unsaturated fats, found in corn, soybean, peanut and other oils, and mono-unsaturated fats, found in olive, canola, safflower, avocado and other oils. The advisory reports that:  

  • Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent –similar to that achieved by cholesterol-lowering drugs, known as statins.
  • Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease.
  • Several studies found that coconut oil – which is predominantly saturated fat and widely touted as healthy – raised LDL cholesterol in the same way as other saturated fats found in butter, beef fat and palm oil.
  • Replacement of saturated fat with mostly refined carbohydrate and sugars is not associated with lower rates of CVD.

“A healthy diet doesn’t just limit certain unfavorable nutrients, such as saturated fats, that can increase the risk of heart attacks, strokes and other blood vessel diseases. It should also focus on healthy foods rich in nutrients that can help reduce disease risk, like poly- and mono-unsaturated vegetable oils, nuts, fruits, vegetables, whole grains, fish and others,” Sacks said.

Examples of healthy dietary patterns include the Dietary Approaches To Stop Hypertension (DASH) diet and a Mediterranean-style diet, both of which emphasize unsaturated vegetable oils, nuts, fruits, vegetables, low-fat dairy products, whole grains, fish and poultry and limits red meat, as well as foods and drinks high in added sugars and salt.

Co-authors are Alice H. Lichtenstein, ScD.; Jason H.Y. Wu, MSc., Ph.D.; Lawrence J. Appel, M.P.H., M.D.; Mark A. Creager, M.D.; Penny Kris-Etherton, R.D., Ph.D.; Michael Miller, M.D.; Eric B. Rimm, ScD.; Larry Rudel, Ph.D., Jennifer G. Robinson, Ph.D.; Neil J. Stone, M.D.; Linda Van Horn, R.D., Ph.D. Author disclosures are on the manuscript.

Additional Resources:

###

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country.  Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Darcy Spitz: (212) 878-5940; darcy.spitz@heart.org.

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

]]>Heart NewsThu, 15 Jun 2017 20:00:11 GMTHighlights: Scientific studies that lowered intake of saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent; similar to cholesterol-lowering drugs, known as statins. Several studies found that coconut oil – which is predominantly saturated fat and widely touted as healthy – raised LDL cholesterol the same way as other saturated fats found in butter, beef fat and palm oil. http://newsroom.heart.org/news/replacing-saturated-fat-with-healthier-fat-may-lower-cholesterol-as-well-as-drugs-in-context-of-a-healthy-dietThu, 15 Jun 2017 20:00:00 GMT

Horse, rhythm-and-music therapies may boost recovery after stroke

AHA Heart News - Thu, 06/15/2017 - 15:19
Study Highlights

  • Horseback riding and rhythm-and-music therapies may improve balance, gait, cognition and long-term perception of recovery for stroke survivor’s years after their stroke.
  • Researchers said significant improvements are still possible years after stroke using motivating, comprehensive therapies that combine physical, sensory, cognitive and social components to stimulate and increase brain activity.

Embargoed until 3 p.m. CT / 4 p.m. ET Thursday, June 15, 2017

DALLAS, June 15, 2017 — Horseback riding and rhythm-and-music therapies may improve stroke survivors’ perception of recovery, gait, balance, grip strength and cognition years after their stroke, according to new research in the American Heart Association’s journal Stroke.

A variety of interventions that engage patients in physical, sensory, cognitive and social activities simultaneously target a range of functions. Researchers said this combination of different activities and stimuli, rather than the individual components, appear to produce additional beneficial effects for stroke recovery.

“Significant improvements are still possible, even years after a stroke, using motivating, comprehensive therapies provided in stimulating physical and social surroundings to increase brain activity and recovery,” said Michael Nilsson, M.D., Ph.D. senior author and Director of the Hunter Medical Research Institute and Professor at the University of Newcastle in Australia and University of Gothenburg, Sweden.

Researchers studied 123 Swedish men and women (age 50-75) who had suffered strokes between 10 months and 5 years earlier. Survivors were randomly assigned to rhythm-and-music therapy, horse-riding therapy or ordinary care (the control group). The therapies were given twice a week for 12 weeks.

Researchers found that among the survivors who felt they experienced an increased perception of recovery:

  • 56 percent were in the horse-riding group;
  • 38 percent in the rhythm and music group; and
  • 17 percent in the “control or usual care” group.

The perception of recovery was sustained at three-month and six-month follow-ups.

Horse-riding therapy produces a multisensory environment and the three-dimensional movements of the horse’s back create a sensory experience that closely resembles normal human gait and is beneficial for stroke survivors.

In rhythm-and-music therapy patients listen to music while performing rhythmic and cognitively demanding hand and feet movements to visual and audio cues. Researchers found that the rhythm-and-music activity helped survivors with balance, grip-strength and working memory.

Limitations of the study include the relatively small number of participants and survivors with severe disabilities could not be considered for the therapy. In addition, researchers doubt these therapies would be cost-effective if patients with mild deficiencies had been included.

Further analyses of the study results and follow-up studies involving more participants are planned to help determine efficiency, timing and costs.

Co-authors are Lina Bunketorp-Käll, Ph.D.; Åsa Lundgren-Nilsson, Ph.D.; Hans Samuelsson, Ph.D.; Tulen Pekny, M.D.; Karin Blomvé, M.D.; Marcela Pekna, M.D., Ph.D.; Milos Pekny, M.D., Ph.D.; and Christian Blomstrand, M.D., Ph.D. Author disclosures and funding are on the manuscript.

Additional Resources:

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke –  the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

For Media Inquiries and AHA/ASA Spokesperson Perspective: (214) 706-1173

Karen Astle: (214) 706-1392; karen.astle@heart.org

For Public Inquiries: (800)-AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Heart NewsStroke NewsThu, 15 Jun 2017 20:00:07 GMTStudy Highlights: Horseback riding and rhythm-and-music therapies may improve balance, gait, cognition and long-term perception of recovery for stroke survivor’s years after their stroke. Researchers said significant improvements are still possible years after stroke using motivating, comprehensive therapies that combine physical, sensory, cognitive and social components to stimulate and increase brain activity. http://newsroom.heart.org/news/horse-rhythm-and-music-therapies-may-boost-recovery-after-strokeThu, 15 Jun 2017 20:00:00 GMT

Receiving a clot-buster drug before reaching the hospital may reduce stroke disability

AHA Stroke News - Thu, 06/15/2017 - 13:11
Study Highlights:  

  • A preliminary study shows that giving a clot-busting drug in a mobile stroke unit ambulance may lead to less disability after stroke, compared to when the clot-buster is given after reaching the hospital.
  • The study suggests that ambulances with the personnel and equipment capable of diagnosing ischemic stroke may be worth the extra cost, due to the decrease in patient disability afterward.

Embargoed until 8:12 a.m. CT/9:12 a.m. ET, Thursday, Feb. 23, 2017

HOUSTON, Feb. 23, 2017 – stroke patients receiving clot-busting medications before arriving at the hospital have a lower risk for disability afterward, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Researchers analyzed results from 658 stroke patients who were treated with tPA – a drug that dissolves blood clots. About half of the participants received the clot-busting drug at the hospital, and half received it while still in the ambulance.

This preliminary study showed that three months after stroke, 182 out of every 1,000 patients treated before arriving at hospital were less disabled, including 58 patients who had zero disability, compared to people who received treatment after reaching the hospital.

“Time is brain in acute stroke after vascular collaterals fail, and faster treatment yields better outcomes,” said May Nour, M.D., Ph.D., lead researcher, interventional neurologist and director of UCLA’s Mobile Stroke Rescue Program. “Our study shows pre-hospital clot-busting is a promising, evolving approach to providing tPA stroke therapy. Its better outcomes could offset the increased costs of a mobile stroke unit.”

Past research showed the sooner that a clot-busting tPA drug is given after an ischemic stroke – one in which a clot is blocking blood flow – the better patients fare. But tPA is not indicated and could hurt a patient’s chances if they are having a hemorrhagic stroke, in which a blood vessel ruptures. That is why patients need a CT scan to confirm the type of stroke before receiving tPA.

Every second counts, in the current standard of care, patients who experience stroke-like symptoms and call 9-1-1 arriving to the hospital by ambulance are assessed by clinical examination and imaging (CT or MRI scan) in the Emergency Department. This takes a certain amount of time from the patient’s symptom onset which prompted the 9-1-1 call.

In a mobile stroke unit, a specialized ambulance is equipped with a CT scanner, a paramedic, a critical care nurse, a CT technologist and a neurologist in person or by telemedicine. The ambulance arrives, does the CT on-site, gives the clot-busting drug if indicated and then transports the patient to the hospital.

Nour’s team used data from Berlin’s PHANTOM-S study, which took place from 2011 to 2015 and included 427 participants (median age 72) which were compared to 505 patients who received conventional care with in-hospital clot busting. Researchers analyzed information about patients’ disabilities to determine how many needed to be treated in the mobile stroke unit to yield a greater benefit in disability outcomes when compared to patients who received tPA at the hospital.

The findings bordered on statistical significance, suggesting that future clinical trials with a greater number of patients are needed to show similar benefits.

“People should know the warning signs of stroke and call 9-1-1 as soon as they observe stroke signs,” said Nour. “Treatment then needs to happen as quickly as possible, and a mobile stroke unit may allow that to happen.”

Coauthors include Sidney Starkman, M.D.; Latisha Sharma, M.D.; and Jeffrey Saver, M.D.

Author disclosures are on the abstract.

The study was funded by the Arline and Henry Gluck Foundation.

Additional Resources:

###

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

Note: Actual presentation is 8:12 a.m. CT/9:12 a.m. ET, Thursday, Feb. 23, 2017.

For Media Inquiries and ASA Spokesperson Perspective:

AHA/ASA News Media in Dallas: (214) 706-1173

AHA/ASA News Media Office, Feb. 22-24,

at the George R. Brown Convention Center: (713) 853-8406

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Scientific Conferences & MeetingsStroke NewsThu, 23 Feb 2017 14:12:07 GMTStudy Highlights:  A preliminary study shows that giving a clot-busting drug in a mobile stroke unit ambulance may lead to less disability after stroke, compared to when the clot-buster is given after reaching the hospital. The study suggests that ambulances with the personnel and equipment capable of diagnosing ischemic stroke may be worth the extra cost, due to the decrease in patient disability afterward. http://newsroom.heart.org/news/receiving-a-clot-buster-drug-before-reaching-the-hospital-may-reduce-stroke-disabilityThu, 23 Feb 2017 14:12:00 GMT

Many stroke patients do not receive life-saving therapy

AHA Stroke News - Thu, 06/15/2017 - 13:11
Study Highlights: 

  • Many ischemic stroke patients do not get tPA, which can decrease their chances for recovery.
  • Blacks, Hispanics, women and “Stroke Belters” are less likely to get tPA.
  • Patients treated in large, urban hospitals, stroke-certified hospitals and hospitals participating in the American Heart Association’s Get With The Guidelines®─Stroke program are more likely to get tPA.
  • Patients with private insurance were more likely to receive tPA than those with Medicare.

Embargoed until 7:36 a.m. CT/8:36 a.m. ET, Thursday, Feb. 23, 2017

HOUSTON, Feb. 23, 2017 – Although tPA treatment for stroke is increasing over time, minorities, women and residents of 11 southeastern states that make up the “Stroke Belt” are left behind when it comes to receiving tPA, according to research presented at the American Stroke Association’s International Stroke Conference 2017.

Tissue plasminogen activator, or tPA, is the only treatment approved by the Food and Drug Administration for ischemic stroke, the most common kind of stroke. If administered within 4.5 hours of the first signs of stroke, tPA can dissolve the blood clot and restore blood flow to the affected part of the brain.

“Hospitals, governments and other organizations are undertaking efforts to increase the number of patients who receive tPA,” said Tracy Madsen, M.D., Sc.M., lead researcher and Assistant Professor of Emergency Medicine at Brown University in Rhode Island. “We wanted to see if these quality improvement efforts were making a difference.”

The study reviewed records from the National Inpatient Sample of 563,087 patients (median age 74) who had an ischemic stroke between 2005 and 2011. Overall, 3.8 percent of patients received tPA, with the number growing each year.

Researchers found:

  • Blacks were 38 percent less likely than whites to receive tPA.
  • Hispanics were 25 percent less likely than whites to receive tPA.
  • Women were 6 percent less likely than men to receive tPA.
  • Those with private insurance were 29 percent more likely to receive tPA compared to those with Medicare.
  • Residents of the “Stroke Belt” were 31 percent less likely than those living elsewhere to receive tPA.

Researchers also found that patients discharged from a designated stroke center or a hospital participating in the American Heart Association’s Get With The Guidelines®─Stroke program were more likely to receive tPA. Likewise, patients were more likely to receive tPA at large, urban, or teaching hospitals compared to hospitals discharged from small, rural, or non-teaching hospitals.

Madsen said that the growing number of hospitals participating in the Get With The Guidelines®─Stroke program and legislation requiring emergency services to take stroke patients to regional stroke centers are likely to increase the number of patients receiving tPA.

 “Some previous studies have found that up to three-fourths of patients arrived after the time window for tPA had closed,” Madsen said. “Many patients across all groups do not arrive at the hospital in time, but this is particularly true for underrepresented minorities.”

An important limitation of the study data is that researchers could not determine why patients did not receive tPA.  The study is also limited because we were not able to adjust for patient level factors such as time to arrival and other tPA exclusion criteria, stroke severity, patient education, and socioeconomic status.  “More research needs to be done to help figure out why many patients do not receive tPA,” Madsen said.

“There is also a lot of work to do in the realm of stroke education so that patients recognize stroke symptoms and call EMS immediately,” Madsen said.

According to the American Heart Association’s Heart Disease and Stroke Statistical Update, 795,000 Americans have a stroke every year, causing almost 129,000 deaths. Residents of the Stroke Belt—Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia—suffer even higher rates of stroke and stroke death.

The National Inpatient Sample is the largest publicly available database of inpatient health care in the U.S.

Coauthors are Shannon Melluzo, B.A.; Charles R. Wira III, M.D.; Zainab Magdon-Ismail, Ed.M., M.P.H.; David Day, B.S.; and Toby I. Gropen, M.D.

Author disclosures are on the abstract.

The study was funded by the American Heart Association/American Stroke Association Founders Affiliate, and the Northeast Cerebrovascular Consortium.

Additional Resources:

###

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

For Media Inquiries and ASA Spokesperson Perspective:

AHA/ASA News Media in Dallas: (214) 706-1173

AHA/ASA News Media Office, Feb. 22-24,

George R. Brown Convention Center: (713) 853-8406

For Public Inquiries: (800) AHA-USA1 (242-8721)

heart.org and strokeassociation.org

Life is why, science is how . . . we help people live longer, healthier lives.

]]>Scientific Conferences & MeetingsStroke NewsThu, 23 Feb 2017 13:36:10 GMTStudy Highlights:  Many ischemic stroke patients do not get tPA, which can decrease their chances for recovery. Blacks, Hispanics, women and “Stroke Belters” are less likely to get tPA. Patients treated in large, urban hospitals, stroke-certified hospitals and hospitals participating in the American Heart Association’s Get With The Guidelines®─Stroke program are more likely to get tPA. Patients with private insurance were more likely to receive tPA than those with Medicare. http://newsroom.heart.org/news/many-stroke-patients-do-not-receive-life-saving-therapyThu, 23 Feb 2017 13:36:00 GMT

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